Róisín Shortall (Dublin North West, Social Democrats)
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You would despair, though. It beggars belief that at this stage we do not have an integrated financial management system for a spend of €23 billion. I am not blaming the HSE for that. It should have been funded by the Department of Health and by the Department of public expenditure.

I raise a question with the Department about making the case for an adequate health budget. We know there is a lot of pressure from different sources with regard to health. I welcome that some attention has now been focused on getting better value for money and on productivity because there was always a sense of a black hole there. A huge amount of money was going into this black hole and nobody knew how it was being spent and whether we were getting value for money.

One aspect of the budget I am concerned about is the comments made about this year's budget by IFAC. It talked about demographic changes such as the significantly growing population and the ageing population. IFAC made the point that those demographics were entirely predictable but the budget for health did not take them into consideration. Why is that the case? Was the case not made sufficiently strongly by the Department with regard to costing that huge additional element or was it that the Department of public expenditure was not listening to that? Why did that happen, Mr. Watt?